Ⅰ﹑Ⅱ期子宫静脉内平滑肌瘤病临床及影像学特征  

Clinical and imaging characteristics of intravenous leiomyomatosis in stages Ⅰ and Ⅱ

作　　者：钱海珍 员强 孔杰[2] 孙占国[1] 陈月芹[1] QIAN Haizhen;YUAN Qiang;KONG Jie;SUN Zhanguo;CHEN Yueqin(Department of Imaging,the Affiliated Hospital of Jining Medical University,Jining,Shandong Province 272029,China;Department of Pathology,the Affiliated Hospital of Jining Medical University,Jining,Shandong Province 272029,China)

机构地区：[1]济宁医学院附属医院影像科,山东济宁272029 [2]济宁医学院附属医院病理科,山东济宁272029

出　　处：《实用放射学杂志》2023年第9期1475-1477,1481,共4页Journal of Practical Radiology

摘　　要：目的 探讨Ⅰ、Ⅱ期子宫静脉内平滑肌瘤病(IVL)的临床及影像学特征.方法 收集 8 例经手术病理证实的子宫 IVL患者资料,回顾性分析其临床、影像学表现,重点总结其影像学特征.结果 8 例患者均行 MRI平扫及增强扫描,4 例亦行CT平扫及增强扫描.平扫表现为不均质宫旁肿块,增强后肿块均表现为不均匀明显强化,呈条索状、蠕虫样,并向卵巢静脉、子宫静脉、髂静脉、下腔静脉延续,肿块内及周围见多发迂曲增粗静脉血管影,3 例见"血管内血管征".Ⅱ期 6 例,Ⅰ期 2 例,累及右卵巢静脉及下腔静脉 2 例、右子宫静脉 1 例、左子宫静脉 1 例、左卵巢静脉 2 例、右髂内静脉 2 例.仅 2 例无手术史(25%),余 6 例均有妇科手术史(≥1 次);6 例有子宫肌瘤病史,2 例有子宫腺肌病史.结论 CT及 MRI示子宫旁迂曲蠕虫样肿块向腹盆腔静脉内延伸及特征性的"血管内血管征",有助于 IVL的诊断.Objective To investigate the clinical and imaging characteristics of intravenous leiomyomatosis(IVL)in stages Ⅰ and Ⅱ.Methods Clinical and imaging findings of 8 patients with IVL confirmed by pathology were analyzed retrospectively,with emphasis on the imaging characteristics.Results Eight cases patients all underwent MRI unenhanced and enhanced scan,in which 4 cases per-formed CT scan.The masses showed heterogeneous on conventional CT/MRI,with strip-like and worm-like enhancement,and extended to the ovarian vein,uterine vein,iliac vein or inferior vena cava.There were multiple tortuous and dilated veins in or arounding the masses."Intravascular vessel"was seen in 3 cases.There were 6 cases of stage Ⅱ and 2 cases of stage Ⅰ,in which right ovarian vein and inferior vena cava were involved in 2 cases,right uterine vein in l case,left uterine vein in 1 case,left ovarian vein in 2 cases and right internal iliac vein in 2 cases.Only 2 cases had no history of surgery(25%),while the other 6 cases underwent gynecological surgery(≥1 time).6 cases had a history of hysteromyoma and 2 cases of adenomyosis.Conclusion CT and MRI images show the tortuous worm-like mass extending to the abdominal and pelvic veins,and show the characteristic of"intravascular vessel"sign,which is helpful for the diagnosis of IVL.

关 键 词：子宫 平滑肌瘤病 磁共振成像 计算机体层成像 

分 类 号：R711.74[医药卫生—妇产科学] R445.2[医药卫生—临床医学] R814.42